Bones of the Ankle Anatomy Quiz
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Questions and Answers

Which muscle is part of the first layer of intrinsic muscles on the plantar aspect of the foot?

  • Quadratus Plantae
  • Lumbricals
  • Flexor Digitorum Brevis (correct)
  • Adductor Hallucis
  • What is the primary function of Lumbricals in the plantar aspect of the foot?

  • Extension of the interphalangeal joints (correct)
  • Adduction of the toes
  • Flexion of the toes
  • Abduction of the toes
  • Which intrinsic muscle is responsible for assisting with toe flexion in the sagittal plane?

  • Quadratus Plantae (correct)
  • Flexor Hallucis Brevis
  • Abductor Digiti Minimi
  • Flexor Digiti Minimi Brevis
  • Which ligaments are associated with lateral ankle stability?

    <p>Anterior talofibular and calcaneofibular ligaments</p> Signup and view all the answers

    What do the interossei muscles assist with in the foot?

    <p>IP joint extension and toe abduction</p> Signup and view all the answers

    Which structure serves as the location for the insertion of the plantar fascia?

    <p>Medial tubercle of the calcaneus</p> Signup and view all the answers

    What is the primary function of the central band of the plantar fascia?

    <p>To support the arch during gait</p> Signup and view all the answers

    What are common causes of fractures in the ankle and foot?

    <p>Falls, twisting, or direct impact</p> Signup and view all the answers

    Which imaging method is seldom required for diagnosing foot fractures?

    <p>Ultrasound</p> Signup and view all the answers

    Which ligament is not involved in the support of the ankle joint?

    <p>Sternal ligament</p> Signup and view all the answers

    The thickest and strongest band of the plantar fascia is commonly referred to as what?

    <p>Plantar aponeurosis</p> Signup and view all the answers

    What is a common symptom of an ankle or foot fracture?

    <p>Considerable pain worsened by weight-bearing</p> Signup and view all the answers

    Which tendon is associated with the retinaculum mentioned in the content?

    <p>Flexor hallucis longus tendon</p> Signup and view all the answers

    What is the primary function of sesamoid bones in the foot?

    <p>To alleviate stress on muscles or tendons</p> Signup and view all the answers

    Which of the following describes the anterior-posterior axis of rotation?

    <p>Permits movement in the frontal plane</p> Signup and view all the answers

    What is the reported normal range of motion for dorsiflexion of the ankle?

    <p>0°-16.5°</p> Signup and view all the answers

    In which plane does the talus roll during plantarflexion?

    <p>Posteriorly and glides anteriorly</p> Signup and view all the answers

    What is the primary movement produced by the coupled motion of dorsiflexion, abduction, and eversion?

    <p>Pronation</p> Signup and view all the answers

    What is the anatomical relationship of the medial malleolus to the lateral malleolus?

    <p>The medial malleolus is anterior and superior to the lateral malleolus</p> Signup and view all the answers

    What is the ratio of inversion-to-eversion movement in the subtalar joint?

    <p>2:1</p> Signup and view all the answers

    What describes the axis of the subtalar joint in relation to the sagittal plane?

    <p>Lies 42° superiorly to the sagittal plane</p> Signup and view all the answers

    What is the prevailing understanding of the cause of plantar fasciitis?

    <p>It is mainly due to a degenerative process.</p> Signup and view all the answers

    Which symptom is characteristic of plantar fasciitis?

    <p>Intense heel pain after periods of inactivity.</p> Signup and view all the answers

    Which assessment maneuver is positive in cases of plantar fasciitis?

    <p>Windlass test.</p> Signup and view all the answers

    What is often true about calcaneal spurs?

    <p>Many people with calcaneal spurs do not experience heel pain.</p> Signup and view all the answers

    What is the most common location for Morton's neuroma?

    <p>Third intermetatarsal space.</p> Signup and view all the answers

    How does tightness of the Achilles tendon relate to plantar fasciitis?

    <p>It is often a contributing factor to heel pain.</p> Signup and view all the answers

    What distinguishes plantar spurs from heel bone spurs?

    <p>Plantar spurs are immediately deep to the plantar fascia.</p> Signup and view all the answers

    What should be considered if clinical features of plantar fasciitis are absent?

    <p>An alternative diagnosis should be considered.</p> Signup and view all the answers

    What is Morton's neuroma primarily characterized as?

    <p>A benign fibrotic thickening of the nerve</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of Morton's neuroma?

    <p>Sharp, stabbing pain in the heel</p> Signup and view all the answers

    What angle is considered abnormal for hallux valgus?

    <p>20° and greater</p> Signup and view all the answers

    Which of the following factors is NOT a predisposing factor for hallux valgus?

    <p>High arches</p> Signup and view all the answers

    Which tendon is involved in the rotation of the first metatarsophalangeal joint in hallux valgus?

    <p>Adductor hallucis tendon</p> Signup and view all the answers

    Which condition is characterized by a rigid flatfoot deformity due to congenital vertical talus?

    <p>Pes planus</p> Signup and view all the answers

    What activity is likely to exacerbate symptoms of Morton's neuroma?

    <p>Heavy impact activities like running</p> Signup and view all the answers

    What is the primary cause of inflammation in hallux valgus?

    <p>Medial prominence of the first metatarsal</p> Signup and view all the answers

    Study Notes

    Bones of the Ankle

    • Sesamoid bones are small bones found within tendons or muscles near joint surfaces, functioning as a pulley to reduce stress on the muscle or tendon.
    • The two sesamoid bones, medial and lateral, are located under the big toe joint within the tendons that move the big toe.
    • There are three axes of rotation in the human body: Anterior-posterior (sagittal), Mediolateral (transverse), and Longitudinal (Vertical)
    • The talocrural joint's axis of rotation is oblique to both sagittal and frontal planes, requiring movement in other planes for complete dorsiflexion and plantarflexion.
    • Dorsiflexion range of motion varies between 0-16.5° and 0-25°, which shifts with weightbearing.
    • Plantarflexion range of motion is approximately 0-50°.
    • The talus rolls within the mortise during dorsiflexion and plantarflexion with the talus rolling anteriorly and gliding posteriorly during dorsiflexion, and rolling posteriorly and gliding anteriorly during plantarflexion.
    • The subtalar joint is defined as a one-degree-of-freedom hinge with a tri-planar axis.

    Foot Muscles

    • Extrinsic Muscles (Dorsum of the foot):
      • Extensor Digitorum Brevis
      • Extensor Hallucis Brevis
    • Intrinsic Muscles (Planter aspect):
      • First Layer:
        • Abductor Hallucis
        • Flexor Digitorum Brevis
        • Abductor Digiti Minimi
      • Second Layer:
        • Quadratus Plantae: helps with toe flexion in the sagittal plane
        • Lumbricals: extend the interphalangeal joint
      • Third Layer:
        • Flexor Hallucis Brevis
        • Adductor Hallucis
        • Flexor Digiti Minimi Brevis
      • Fourth Layer:
        • Plantar Interossei
        • Dorsal Interossei: assist with MTP joint flexion, IP joint extension, toe abduction and adduction

    Ankle Joint Ligaments

    • Ankle instability can occur due to ligamentous injury.
    • The anterior talofibular ligament is the most commonly injured ligament in ankle sprains.
    • Clinically diagnosing ankle injury can include assessing gait, swelling, and tenderness to palpation.

    Ankle and Foot Fractures

    • Ankle and foot fractures are caused by falls, twisting injuries, or direct impact.
    • Pain is a primary symptom, often worsening with weightbearing.
    • X-rays are used to diagnose most fractures, but CT or MRI may be required in some cases.
    • Treatment typically involves a splint, shoe, or boot designed for protection.

    Plantar Fascia

    • The plantar fascia connects the calcaneus (heel bone) to the toes, supporting the arch of the foot.
    • Three distinct bands make up the plantar fascia: medial, central (plantar aponeurosis), and lateral.
    • The plantar fascia stabilizes the arch during gait through the windlass mechanism.

    Plantar Fasciitis

    • It is now considered a degenerative process rather than solely inflammatory.
    • Symptoms include:
      • Insidious onset of heel pain
      • Intense heel pain during the first steps after waking or inactivity, relieving with activity
      • Pain worsening later in the day or with prolonged standing or walking.
    • Risk factors include age, weight, and activity levels.
    • Examine the foot at weightbearing and non-weightbearing; signs of plantar fasciitis include:
      • Tenderness upon palpation of the plantar heel area
      • Limited ankle dorsiflexion range
      • Positive 'Windlass test'

    Calcaneal Spur

    • Calcaneal Spurs are bone projections on the calcaneus, which may be either dorsal or plantar.
    • The etiology of these spurs is a complex issue and may be linked to degenerative, inflammatory, traction, repetitive trauma, bone formation, and vertical compression theories.
    • Although they are not the direct cause of plantar fasciitis, they can be formed due to long-standing tension on the plantar fascia insertion.

    Morton’s Neuroma

    • It is a compression neuropathy of the common digital plantar nerve.
    • Most often occurs in the third intermetatarsal space (66% of cases).
    • Not a true neuroma but a benign fibrotic thickening of the nerve due to irritation.
    • Risk factors include:
      • Chronic, repetitive trauma.
      • High-arch feet.
      • Tight or ill-fitting footwear.
      • Nerve ischemia.
      • Repetitive heavy impact on the feet.
    • Symptoms include:
      • Pain in the forefoot.
      • Pain worsening with increased activity or specific footwear.
      • "Pebble" or "lump" sensation under the metatarsal walking.
      • Sharp, stabbing, burning, or tingling sensation in the affected nerve distribution.

    Hallux valgus

    • The great toe (hallux) deviates laterally away from the midline towards the lesser toes.
    • Less than 15° is considered normal, 20°+ is abnormal, and 45-50° is severe.
    • Causes medial prominence of the first metatarsal head with inflammation of the overlying bursa and soft tissues.
    • Predisposing factors include:
      • Poorly-fitting footwear.
      • Age and female gender.
      • Family history.
      • Pes planus.
      • Achilles tendon contracture.
      • Ligamentous laxity.

    Pes Planus

    • Several causes for flat feet include genetics, injury, and underlying medical conditions.
    • Congenital vertical talus leads to a rigid flatfoot deformity.

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    Ankle and Foot Anatomy PDF

    Description

    Test your knowledge on the anatomy of the ankle, including sesamoid bones, joint mechanics, and range of motion for dorsiflexion and plantarflexion. This quiz covers the essential functional aspects of the ankle's movement and structure.

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